Rheumatoid arthritis can affect the ankle joints in a similar way to other joints, producing stiffness, edema, and discomfort.
Rheumatoid arthritis, often known as RA, is a chronic condition that most usually affects the hands and feet, but it can also affect the ankles in rare cases.
Smaller joints, such as the toe joints in the foot, are often the first to be affected by the illness. It may then progress to bigger joints, such as the ankles, before finally disappearing. The presence of RA in the ankles can make walking difficult and create significant discomfort.
RA affects the ankles in many ways, and this article will look at how RA affects the ankles, including the symptoms and ways to decrease pain and swelling.
What is the impact of RA on the ankles?
Rheumatoid arthritis symptoms tend to come and go in cycles known as flares, which can last anywhere from a few days to several weeks. People may find that their symptoms are worse first thing in the morning or last thing in the evening.
Due to the long-term inflammation that occurs in RA, the ankle joints might experience irritation and stiffness similar to that experienced in other joints. As a result of the effects of time on the construction of the ankle joints, it is possible for them to develop permanent alterations in shape.
The ankle joint is the joint that joins the bones of the leg to the bones of the foot. It is composed of two tiny joints that work together as a hinge to allow the foot to move. Walking, for example, is dependent on the normal functioning of the ankle joints.
In the ankle joint, the bones are cushioned by cartilage, which prevents the bones from rubbing against one another. Over time, RA causes this to break down, increasing the friction between the bones.
It is possible that the contact between bones will cause inflammation around the ankle joint. Ankle ligament injury can also result in the surrounding tissues that support the joint becoming weak and unstable, making the ankle joint incapable of providing enough support.
Many persons who have RA in their ankles also have additional symptoms in their feet, which is common. The following are some of the most commonly impacted areas:
- the toes
- the middle of the foot and bones below the ankle (if the tendons and ligaments become lax, this can cause a flat foot)
- the front ball of the foot
- the heel of the foot, particularly the Achilles tendon when nodules appear
How does RA in the ankles feel?
The most noticeable sign of RA in the ankle joint is inflammation, which causes the joint to swell, become painful, and become stiff. This can affect a person’s ability to walk and stand because it restricts the joint’s range of motion.
Symptoms may be modest and uncommon in the early stages of the disease. Walking up a hill, for example, may cause people to experience discomfort because the increased pressure placed on the ankle joints causes the joints to swell.
After a period of time, inflammation can grow more severe, resulting in damage to the joints and the tissues around them. The severity of the symptoms increases at this point. The ankles may become uncomfortable and stiff on a regular basis, particularly when walking or standing.
During the course of a chronic condition, the ankle joint can become fused and its range of motion reduced, which has a substantial influence on gait since the foot is unable to flex to allow for the essential push off. However, as a result of advancements in therapy, this is becoming increasingly infrequent.
In the case of chronic RA causing structural abnormalities in the foot, this might result in callouses and bunions as well as nodules and corns.
Other symptoms of RA, in addition to joint inflammation, may include the following:
Diagnosis
A physical examination by a doctor is frequently sufficient to diagnose RA. They will also physically evaluate the ankles for symptoms of inflammation or other abnormalities, as well as perform a range of motion test on the ankles.
While doctors will mostly diagnose RA based on symptoms, they may also request further testing in order to obtain more specific information.
For example, to determine the degree and location of joint damage, doctors frequently offer X-rays, ultrasounds, and even MRI scans to patients. This is more likely to occur when a doctor detects RA in the ankle since the early damage is less visible than in other places of the body.
It is possible to use blood tests to identify whether antibodies in the blood indicate RA or to rule out other possible causes of the ailment.
Treatment
The specific cause of RA is still a mystery. Researchers are currently looking into the most effective therapies for the disorder at this time.
When it comes to treating RA, a variety of approaches may be used, including workouts, a low-inflammatory diet, and medication to alleviate inflammation and pain. Exercise, a low-inflammatory diet, and medication to alleviate inflammation and pain are all options.
The use of tobacco products is a known risk factor for getting RA and for symptoms deteriorating; thus, quitting smoking may improve the long-term outlook for those suffering from the condition.
The ankle joints should be exercised.
Maintaining mobility in the ankle joints throughout the day can help to increase flexibility and range of motion in the affected region.
Exercises may be created to ensure that the ankles remain flexible while without putting too much strain on them and risking further injury to the joints.
In addition to providing additional support, strengthening the muscles around the joints can help prevent future injury.
People can try particular exercises that stretch and strengthen the ankle joints in order to alleviate discomfort, stiffness, and edema, such as the ones listed below:
- Exercises to strengthen the foot and ankle muscles in order to reduce pressure on the joints are recommended.
- stretches to alleviate stiffness in the tissue surrounding the ankles
Physical therapists can design workout programs that are specific to the needs of each patient. People will have to figure out which workouts are the most beneficial for them.
Lifestyle changes
In certain circumstances, people may need to cease or reduce activities that place an excessive amount of strain on their ankles.
To reduce the stress on the ankles when walking, it may be necessary to employ equipment that provides support, such as a cane or walking frame. Orthopedic shoes may also be effective in some situations.
Maintaining a healthy weight might assist to alleviate some of your discomfort. It is possible that being overweight will increase the pressure on the ankle joints. A doctor may recommend that you follow a healthy, anti-inflammatory diet or begin a new exercise regimen.
Medication
It is vital to reduce inflammation in order for a person to be able to decrease swelling in their ankles and manage their discomfort.
There are several drugs that can help with the symptoms of RA and may also help to decrease long-term damage to the joints, such as:
- painkillers to manage uncomfortable symptoms
- nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation
- disease-modifying anti-rheumatic drugs (DMARDs)
- biologics
The management of inflammation can aid in the restoration of ankle and other joint mobility. If RA has caused irreversible damage to the ankle joint, medicine will not be able to cure the damage, but it may be able to alleviate pain, prevent additional damage, and improve overall quality of life in the meantime.
Corticosteroid injections into the ankle can also be used by doctors to relieve severe inflammation fast, therefore preventing injury or alleviating discomfort.
Because DMARDs and biologics have the potential to depress the immune system, people should be informed that they may be more susceptible to infection if they take these medications.
Surgery
Individuals who have advanced types of RA or who do not react well to therapy may be candidates for surgical intervention.
The kind of arthritis and the amount of the damage will determine the sort of surgery that is recommended by experts. Parts of the ankle’s bones are fused together during some ankle operations to keep them from rubbing against one another and creating inflammation and discomfort.
During more severe situations, such as when fusion has not been successful, ankle replacement surgery may be an option to relieve pain and restore joint mobility.
Conclusion
RA is a chronic condition that requires ongoing treatment. The symptoms are generally modest at first, but they can worsen with time, causing substantial pain and mobility difficulties. Ankle RA may make it difficult to stand or walk correctly if it affects the ankles.
When a flare occurs, however, a variety of effective therapies are available; a combination of treatments can help improve people’s quality of life.
Sources
- https://www.arthritis.org/about-arthritis/where-it-hurts/ankle-pain/ankle-anatomy.php
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3468872/
- https://www.medicalnewstoday.com/articles/323033
- https://health.clevelandclinic.org/diagnosed-with-arthritic-ankles-what-you-can-expect-from-treatment/
- https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html
- https://orthoinfo.aaos.org/en/diseases–conditions/rheumatoid-arthritis-of-the-foot-and-ankle
- https://onlinelibrary.wiley.com/doi/pdf/10.1002/acr.20409
- https://www.nras.org.uk/the-foot-and-rheumatoid-arthritis
